Missouri Digital Heritage :: Collections :: Birth & Death Records Database :: Birth Record Detail

Missouri Birth & Death Records Database

Permanent Record of Births

County Roll Number Page Number
Pike C 5348 273

Date of Return
(Month/Day/Year)
  1. Name of Child
  2. Sex
  3. No. of Child of this Mother
Race or Color
  1. Date of Birth
  2. Place of Birth
3/25/1884
  1. Walter Carroll
  2. Male
  3. Third
White
  1. Feb. 23rd 1884
  2. Clarksville MO.

  1. Nationality of Father
  2. Place of Birth
Age
  1. Nationality of Mother
  2. Place of Birth
Age
  1. American
  2. Clarksville MO.
29
  1. American
  2. Louisiana MO.

  1. Full Name of Mother
  2. Maiden Name of Mother
  3. Residence of Mother
  1. Full Name of Father
  2. Occupation
  1. Name and Address of Medical Attendant
  2. Name and Address of Person making Certificate
  3. Returned by
  1. Ida May Carroll
  2. Ida M. Calvert
  3. Clarksville MO.
  1. Edward Clark Carroll
  2. Hardware Clerk
  1. C. T. Pepper Clarksville MO.
  2. C. T. Pepper
  3. C. T. Pepper

NOTE
 


Due to possible errors or discrepancies in this abstract it is recommended that researchers request a print copy. To request a copy of this record, please print a copy of this page and mail it to the Missouri State Archives, PO Box 1747, 600 W. Main Street,  Jefferson City, MO  65101 with a check or money order for $1.00 made payable to the Missouri State Archives.  Please include a #10 business size, stamped, self-addressed envelope with each request.  Please submit one photocopy request at a time.
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